End “corridor care” in A&E, says College

  • Date: 16 December 2019

CARING for people in A&E corridors cannot be allowed to continue as new figures show a direct link between overcrowding and patient harm.

The Royal College of Emergency Medicine (RCEM) made the call in response to a Guardian report on a study analysing the care received by more than four million people who attended emergency departments (EDs) in England.

The research found that almost 5,500 patients have died since 2016 because they waited anywhere between six and 11 hours on a trolley for a bed. It found that those deaths represent the total "estimated attributable mortality" from the delays.

RCEM president Dr Katherine Henderson described the findings as "alarming" and said they echo what the College has warned for some time: that "emergency department crowding kills".

She said there is overwhelming evidence that so-called "corridor care" is directly associated with harm for both patients and staff.

She said: "The harm for patients includes delays to getting the right care, simply not getting timely treatment, lack of privacy and dignity and increased complication rates for their illness.

"It has been clear for a long time that this results in higher rates of death in patients who are admitted from overcrowded departments.

"The scale of the effect has previously been described as being of the order of at least a 10 per cent increase in mortality."

While the cause of the increase in mortality is not known, Dr Henderson said it was likely to be a result of cumulative delays in care and errors in care due to overcrowding or from lack of staffing, both in EDs or in the system as a whole.”

She said the College awaited the final peer reviewed publication of the paper from Dr Chris Moulton and Dr Cliff Mann "with interest".

She added: "What is clear is that corridor care cannot be allowed to continue."

She confirmed the College is working with NHS England to develop metrics which measure flow and crowding and are "essential" to ensure patient safety. She called on the government to take steps to address the "dangerously overloaded" system by boosting staff and bed numbers.

An NHS spokesperson told the Guardian: "Actually, the latest official figures show that your chances of dying if you are admitted to hospital are lower than they have been at any time in the last five years despite patients increasingly being older and sicker."

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